“We don’t want to have rural people deterred from seeking medical assistance when the statistics show they need more medical care, not less,” Ms Johnson said.

“Rural areas tend to have poorer health outcomes, they’re less likely to go and see a GP and they carry a greater burden of chronic disease.”

She said it made economic sense to encourage patients to seek preventative and primary care, rather than spending hundreds of thousands of dollars on later treatment, including dialysis machines or surgical operations.

She said she was pleased to see the AMA model emphasise quality general practice, but said more work needed to be done to recognise the unique position of rural doctors, who often performed after hours and emergency work on top of their general practice.

The whole of the $6.15 copayment would be pocketed by GPs, rather than the majority being diverted to a medical research fund, a proposal that has come in for criticism.

But AMA president Brian Owley said it was vital to keep money in preventative care at a GP, which he said was the answer to managing Australia’s worrying rise in chronic disease.

“We can’t be taking money out of primary health care to put into tertiary level research,” he said.

“Where patients can afford to contribute, we ask them to contribute.”

Nurses reject doctors’alternative

THE NSW nurses’ union has rejected the AMA’s alternative, Tamworth union representative Jill Telfer saying even a reduced co-payment option was still a step too far.

The NSW Nurses and Midwives’ Association (NSWNMA) and Doctors Reform Society (DRS) said any form of co-payment was an “ideological attack” on the universality of Medicare and accused the AMA of trying to “dupe” the Australian public.

Mrs Telfer, a nurse and the Tamworth branch secretary of the NSWNMA, said the AMA proposal did not address whether co-payment exemptions would be available for vital diagnostic imaging and pathology services, including blood tests, X-rays and scans.

“It’s still a co-payment,” she said.

“It sets us on the path of an Americanised user-pay system and we don’t want that.

“Both proposals are unacceptable. People with chronic illnesses who are not on concession cards might choose not to have treatment, which will put a bigger burden on hospitals.”

DRS national president Con Costa said there was “no evidence” a co-payment would improve health outcomes or the quality of primary care.